Several resurfacing opitions exist for patients suffering from isolated loss of cartilage in the knee. The knee is comprised of three compartments: the medial (inside), the lateral (outside), and the patellofemoral (knee cap area).(picture with arrows) Osteoarthritis can afflict one, two, or all three of these compartments, making simple activities painful. It is estimated that over 65-70% of patients posses damage to only one or two major areas in the knee with preservation of normal cartilage in one or more compartments. In these instances, resurfacing only the damaged area while preserving the anterior cruciate and posterior cruciate ligaments makes sense.
Patients with partial knee replacements or resurfacings recover much faster than a full knee replacement. When able to compare the partial knee to a contralateral total knee replacement patients often state the partial knee feels better and more normal. The results can be dramatic.
Unicompartmental Knee replacement focuses on resurfacing either the inside or outside portion of the knee. A computer is used, along with an MRI of the leg, to accurately place your partial knee during the surgery. A patient specific guide - specific and custom to your knee - is created to allow this to happen accurately and efficiently. The knee cap cartilage, front of the knee, and unresufraced compartment are preserved along with the vital ligaments. When performed appropriately the results are equal to knee replacement and if failure does occur the results of the procedure to convert a partial to a total knee replacement can be as good as a first time knee replacement. In other words, in many cases you do not burn bridges with a partial knee replacement.
Patellafemoral Resurfacing is an excellent option for patients with isolated arthritis effecting the knee cap (patella). The undersurface of the knee cap and the area in which it tracks is resurfaced preserving the normal areas of the knee. Most of the articular cartilage and all of the knee ligaments are preserved leading to a more mechanically normal knee. This can be a good option in younger patients and patients who wish to remain active with arthritis effecting the knee cap (patellafemoral) compartment.
Bicruciate, Ligament Sparing, ACL PCL Retaining Knee Replacement
Bicruciate retaining knees were used in the infancy of knee replacement and met with mixed results. With newer materials and design we now have an ACL and PCL retaining knee which may be appropriate for some patients. We are currently involved in the development and use of this implant.